Neurological research
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Neurological research · Mar 2010
Comparative StudyCorrelation of findings in advanced MR techniques with global severity scales in patients with some grade of cognitive impairment.
Some previous studies in patients with mild cognitive impairment and Alzheimer's disease have probed changes in the results of (1)H magnetic resonance spectroscopy and perfusion- and diffusion-weighted imaging. The purpose of this work was to correlate the results of perfusion- and diffusion-weighted imaging and magnetic resonance spectroscopy with the results of two global severity scales in cognitive impairment: the clinical dementia rating (CDR) and the global deterioration scale (GDS). ⋯ In patients with cognitive impairment, there is a good correlation between CDR and GDS. The tool that showed the closest correlation with the clinical scales (CDR and GDS) was magnetic resonance spectroscopy in the left occipital cortex and posterior cingulate gyrus. Perfusion- and diffusion-weighted imaging are tools with a weak correlation with clinical scales, GDS being unique that gave us significant statistical results; this could be explained by the major number of items considered for cognitive impairment (GDS 2 and 3) compared with CDR (CDR 0.5). Magnetic resonance spectroscopy can be used in the diagnostic, following and evaluation of the response to the treatment in patients with cognitive impairment (mild cognitive impairment and Alzheimer's disease), complementing the information obtained in the clinical evaluation.
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Neurological research · Mar 2010
Comparative StudyHypertonic saline more efficacious than mannitol in lethal intracranial hypertension model.
Medical management of brain edema and elevated intracranial pressure (ICP) is a crucial challenge in neurosurgical practice. Depending on the cause, the treatments for brain edema fall into three categories: stabilization of the blood-brain barrier, depletion of brain water and surgical decompression. Although mannitol is the mainstay of hyperosmolar therapy, hypertonic saline (HS) is emerging as an effective alternative to traditional osmotic agents. ⋯ The findings demonstrate higher efficacy of the 10% NaCl treatment in this comparison with 20% mannitol. Further efforts should be directed toward development of clinical studies using iso-osmotic doses of mannitol and HS in specific etiologies of intracranial hypertension.
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Neurological research · Mar 2010
Comparative StudyAmelioration of rCBF and PbtO2 following TBI at high altitude by hyperbaric oxygen pre-conditioning.
Hypobaric hypoxia at high altitude can lead to brain damage and pre-conditioning with hyperbaric oxygen (HBO) can reduce ischemic/hypoxic brain injury. This study investigates the effects of high altitude on traumatic brain injury (TBI) and examines the neuroprotection provided by HBO preconditioning against TBI. ⋯ High altitude aggravates TBI significantly and HBO pre-conditioning can attenuate TBI in rats at high altitude by improvement of rCBF and PbtO(2). Pre-treatment with HBO might be beneficial for people traveling to high altitude locations.
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Neurological research · Feb 2010
The influence of configuration and location of ruptured distal cerebral anterior artery aneurysms on their treatment modality and results: analysis of our casuistry and literature review.
To assess the influence of configuration and location of ruptured distal cerebral anterior artery aneurysms on their treatment modality and results. ⋯ The results of this study suggest that patients with infracallosal basic configured aneurysms are expected to benefit from endovascular procedures, whereas better radiological and clinical results can be obtained in surgically treated patients harboring supra- or infracallosal aneurysms of complex configuration.
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Neurological research · Feb 2010
Drug transporters are altered in brain, liver and kidney of rats with chronic epilepsy induced by lithium-pilocarpine.
Pharmacoresistance is a common problem hindering treatment of epilepsy. A possible cause for this resistance is the overexpression of efflux drug transporters, e.g. P-glycoprotein (P-gp), which may decrease extracellular antiepileptic drugs levels in brains of intractable epilepsy patients. Another transmembrane drug transporter is the organic anion transporting polypeptide 2 (Oatp2), which is colocalized with P-gp in many polarized tissues. However, a role for Oatp2 in the development of multidrug resistance has not been established. In the present work, we investigated the expression of drug transporters Oatp2 and P-gp in brain, liver and kidney of rats with chronic epilepsy induced by lithium-pilocarpine. ⋯ Organic anion transporting polypeptide 2 and P-gp colocalized in tissues that are important in drug absorption, metabolism and excretion. Seizures seem to induce the cerebral changes of P-gp and Oatp2. However, the changes of expression of two transporters exhibit the opposite trend. Organic anion transporting polypeptide 2 might play a different role than P-gp in intractable epilepsy. Our data provide a basis for the assessment of the role of uptake transporters and efflux pumps in the development of intractable epilepsy.